The proposed study focuses on Hispanic women of Mexican origin or descent experiencing their first birth in two Los Angeles hospitals. The premise underlying the study is that the anticipation of the birth experience and reactions during childbirth vary from culture to culture and when women interact with a health care system developed in a different cultural context, dissonances may develop. The result can be a difficult experience for both patient and provider, and increase potential for negative consequences such as prolonged labor, increased medication during labor and delivery, more cesarean sections, and poor maternal-infant attachment. This study will interview 600 women of Mexican origin or descent once in the last month of pregnancy and once in the hospital after delivering. Data on the delivery will be transferred from patient charts. A subsample of 60 women will be observed during labor and delivery. The health care providers involved in these births (approximately 100) will provide their reactions to each birth and will also be interviewed on their own backgrounds and their perceptions of Hispanic patients after all the observations are concluded. Path analysis and multiple regression will be among the techniques used to measure the extent to which the quality of birth experience for the women is modified as a function of their background, attitude toward birth and knowledge of the process, medical course of labor and delivery, and condition of the infant. The same analysis will be applied to the health care providers to see the extent to which their experience is a function of their background, the women's knowledge, attitudes and behavior, the involvement of the woman's family and friends, the medical course of labor and delivery and the child's condition. Factors affecting the medical course of labor and delivery will also be explored.